Psychiatric illness in patients with end-stage renal disease

Kimmel, Paul L.; Thamer, Mae; Richard, Christian; Ray, Nancy

doi:10.1016/s0002-9343(98)00245-9

Cited by 208 publications

(178 citation statements)

References 19 publications

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“…In this study, chronic renal patients with some level of depression presented a close percentage to that reported in literature, in which the prevalence of depression varies between 5 and 25% in hemodialysis patients 5 . The mean age of the total population was 49.7 years, a value that is similar to that of another study that presented mean age of 53.1 years, ranging from 18 to 81 6 .…”

Section: Discussionsupporting

confidence: 86%

A qualidade de vida dos pacientes renais crônicos em hemodiálise na região de Marília, São Paulo

Ferreira¹,

Filho²

2011

J. Bras. Nefrol.

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Introduction: Hemodialysis is responsible for significant alterations in the quality of life of chronic renal patients. Objective: To compare the quality of life of patients on hemodialysis without depression (A) and those with some level of depression (B). Methods: This was a transversal and descriptive study in which the Beck Depression Inventory (BDI) and the WHOQOL-bref scale were used. Results: The studied sample consisted of 130 patients, 65.15% in A, and 33.84% in B. The highest levels of depression were related to longer periods of treatment. Quality of life indexes were better for A, and, as certain domain increased, also were the others. More differences were observed in the Psychological (A: 69.40 and B: 49.22) and Physical (A: 62.81 and B: 42.19) Domains; and the Social Relations Domain had a better average between the populations, as well as a better correlation with the other domains. Conclusion: Although there was a low prevalence of depression among hemodialysis patients, some investments should be made in the social, psychological and physical support aiming to improve their quality of life.

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Section: Discussionsupporting

confidence: 86%

A qualidade de vida dos pacientes renais crônicos em hemodiálise na região de Marília, São Paulo

Ferreira¹,

Filho²

2011

J. Bras. Nefrol.

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“…For example, negative affect as a result of depression can be difficult to distinguish from the known uremic symptoms of irritability, cognitive dysfunction, and encephalopathy or from drug effects or inadequate dialysis. In addition, comorbid depression, or depression that coexists with another psychiatric or medical illness, may render depression relatively refractory to treatment (1)(2)(3)6,18,21). Although recent work has emphasized the place of pharmacotherapy for depression, nondrug therapies have also shown to have a place in its treatment (22)(23)(24).…”

Section: P Revious Studies Established Depression As the Primary Mentmentioning

confidence: 99%

Depression and Anxiety in Urban Hemodialysis Patients

Cukor

Coplan

Brown

et al. 2007

Clinical Journal of the American Society of Nephrology

237

202

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Depression is well established as a prevalent mental health problem for people with ESRD and is associated with morbidity and mortality. However, depression in this population remains difficult to assess and is undertreated. Current estimates suggest a 20 to 30% prevalence of depression that meets diagnostic criteria in this population. The extent of other psychopathology in patients with ESRD is largely unknown. The aim of this study was to expand the research on psychiatric complications of ESRD and examine the prevalence of a broad range of psychopathology in an urban hemodialysis center and their impact on quality of life. With the use of a clinician-administered semistructured interview in this randomly selected sample of 70 predominately black patients, >70% were found to have a psychiatric diagnosis. Twenty-nine percent had a current depressive disorder: 20% had major depression, and 9% had a diagnosis of dysthymia or depression not otherwise specified. Twenty-seven percent had a current major anxiety disorder. A current substance abuse diagnosis was found in 19%, and 10% had a psychotic disorder. The mean Beck Depression Inventory score was 12.1 ؎ 9.8. Only 13% reported being in current treatment by a mental health provider, and only 5% reported being prescribed psychiatric medication by their physician. A total of 7.1% had compound depression or depression coexistent with another psychiatric disorder. The construct of depression was also disentangled from the somatic effects of poor medical health by demonstrating a unique relationship between depressive affect and depression diagnosis, independent of health status. This study also suggests the utility of cognitive variables as a meaningful way of understanding the differences between patients who have ESRD with clinical depression or other diagnoses and those who have no psychiatric comorbidity. The findings of both concurrent and isolated anxiety suggest that the prevalence of psychopathology in patients with ESRD might be higher than previously expected, and the disorders may need to be treated independently. In addition, the data suggest that cognitive behavioral therapeutic techniques may be especially advantageous in this population of patients who are treated with many medications.

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“…Successful renal transplantation has been reported in patients with underlying psychiatric disorders before transplant (2). Psychiatric disorders are more common in chronic dialysis patients than in the general population (3) and have been shown to adversely impact survival in hemodialysis patients (4). However, psychosis occurring after renal transplantation has been infrequently described (5)(6)(7)(8)(9).…”

mentioning

confidence: 99%

Hospitalized Psychoses after Renal Transplantation in the United States

Abbott¹,

Agodoa

O’Malley

2003

Journal of the American Society of Nephrology

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ABSTRACT. Although it is recommended that renal transplant (RT) candidates routinely undergo screening for mental health–related conditions, national statistics for psychoses after RT have not been reported. This is a historical cohort study of 39,628 renal transplant recipients in the United States Renal Data System between July 1, 1994, and June 30, 1998, and followed until December 31, 1999. Adjusted hazard ratios (AHR) for time to hospitalization for both a primary and secondary discharge diagnosis of psychoses (ICD-9 codes 290.x-299.x) after RT and mortality/graft loss after psychosis were assessed by Cox Regression. In addition, rates of psychosis were compared with 178,986 patients with Medicare as their primary payer who started chronic dialysis from April 1, 1995, to June 29, 1999. The incidence of psychoses was 7.5/1000 person-years (PY) after RT compared with 7.2/1000 PY for all patients on chronic dialysis and 9.6/1000 PY for dialysis patients aged 65 yr or younger. Among RT recipients, graft loss (AHR, 2.97; 95% CI, 2.19 to 4.02), allograft rejection, and cadaveric donation were independently associated with psychosis, which was associated with an increased risk of both death (AHR, 2.09; 95% CI, 1.71 to 2.56; P < 0.001) and graft loss (AHR, 1.79; 95% CI, 1.15 to 2.78; P = 0.01). Graft loss due to noncompliance was significantly more common after psychosis (9.0% versus 3.7% in patients not hospitalized for psychosis; P < 0.001). The incidence of hospitalized psychosis was not substantially higher after RT compared with chronic dialysis patients. Psychoses were independently associated with increased risk of death and graft loss after renal transplantation, possibly mediated through medical non-adherence. E-mail: kevin.abbott@na.amedd.army.mil

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Psychiatric illness in patients with end-stage renal disease

Cited by 208 publications

References 19 publications

A qualidade de vida dos pacientes renais crônicos em hemodiálise na região de Marília, São Paulo

A qualidade de vida dos pacientes renais crônicos em hemodiálise na região de Marília, São Paulo

Depression and Anxiety in Urban Hemodialysis Patients

Hospitalized Psychoses after Renal Transplantation in the United States

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